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Value of C-reactive protein in differentiation between tuberculous and malignant pleural effusion

Abstract

Background

Few studies had reported the value of Creactive protein (CRP) in differentiating between tuberculous pleural effusion (TBPE) and malignant pleural effusion (MPE).

Aim

The aim of this study was to investigate the diagnostic value of CRP in differentiating between TBPE and MPE.

Settings and design

This prospective study was conducted in a University Hospital.

Patients and methods

During a period of 18 months, a prospective study included 59 adult patients with pleural effusion. The study included two groups: group I, which included 29 patients with TBPE, and group II, which included 30 patients with MPE. Serum C-reactive protein (s-CRP) and pleural fluid C-reactive protein (p-CRP) were measured and compared in both groups, using enzyme-linked immunosorbent assay.

Results

The mean values of s-CRP were 28.34±14.41 and 27.87±13.21 mg/dl in TBPE and MPE, respectively, with no significant difference. The mean values of p-CRP were 36.51 ±3.91 and 26.39±7.57 mg/dl in TBPE and MPE, respectively, with a highly significant difference (P=0.001). There were significantly positive correlations between s-CRP and p-CRP in both TBPE and MPE (r=0.685 and P=0.001; r=0.594 and P=0.006, respectively). With the use of cutoff values of 31.6 and 43.3 mg/l for p-CRP and s-CRP, sensitivity and specificity were 89.47 and 80.00% for p-CRP, and 15.79 and 100.00%, respectively, for s-CRP. The area under the receiver operating characteristic curve of p-CRP was 0.888, superior to that of s-CRP (0.525).

Conclusion

Measurement of CRP levels in the pleural fluid has a good utility in the diagnostic workup of patients with pleural effusion. p-CRP can be a useful adjunctive test, as a potential differentiator between TBPE and MPE.

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Correspondence to Sherif A. A. Mohamed.

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Mohamed, S.A.A., Agmy, G.R., Wafy, S.M. et al. Value of C-reactive protein in differentiation between tuberculous and malignant pleural effusion. Egypt J Bronchol 11, 49–55 (2017). https://doi.org/10.4103/1687-8426.198999

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Keywords

  • C-reactive protein
  • differentiation
  • malignant
  • pleural effusion
  • tuberculosis
  • value